Posttraumatic Art

December 10, 2012

    Recovery from PTSD requires that one address the trauma at some point.  Dream revision therapy, as described in earlier blogs, is a method for addressing trauma through posttraumatic dreams or nightmares.  If the dream is metaphorical (i.e., being pursued by a tidal wave or a snake rather than an assailant), one can revise the metaphorical situation without addressing the trauma directly.  This can be less stressful than reviewing the actual details of a trauma, as in other types of currently practiced PTSD therapy: prolonged exposure (PE) or eye movement desensitization and reprocessing (EMDR).

Art is another means of addressing one’s past trauma indirectly.  One can depict the trauma using colors, textures, shapes, and scenes, presented either realistically or in abstract form.  Such purely visual depiction, without the need for words, can be healing in and of itself.  Mastering the depiction process (making a preliminary sketch; selecting, mixing, applying paint; integrating the different elements into a single composition) becomes a metaphor for mastering the trauma.

During my residency training in Irvine, California, in the early 1990’s, I spent a few hours per week for most of a year working with adolescents who had been admitted to the locked adolescent inpatient psychiatric unit of a general hospital (University of California, Irvine, Medical Center).  Among the adolescents were many who had been traumatized as children.  I knew from talking with the adolescents during individual therapy sessions that many of them were having nightmares.

Since I was interested in dreaming, I came up with the idea of conducting a weekly art therapy group that involved drawing a picture of a recent dream.  I knew little about art therapy, but an experienced art therapist was assigned to the adolescent inpatient unit several times per week, and we worked together on the project.

Each art therapy session was designed to last two hours; all adolescents currently on the unit were expected to participate.  Typically there were 10-15 participants.

During the first hour, each adolescent was provided with art materials, including an easel.  They were asked to draw a picture of one of their own dreams, preferably recent, either during their stay on the unit or shortly before their arrival on the unit.

During the second hour, each adolescent was given up to five minutes to stand next to their painting and explain it to the group.  Staff, including myself, were present to facilitate the process, making sure that every adolescent had a chance to speak.

Results were impressive.  Adolescents who had been quite closed and reticent about expressing their feelings prior to the art therapy class, had no difficulty describing their pictures.  Furthermore, staff on the unit reported that one-on-one sessions with individual adolescents after the class were unusually lively and helpful.  It seemed evident that producing art was beneficial to traumatized adolescents in helping them master and describe their traumatic experiences.